口服非甾体抗炎类药品疼痛管理效果临床综合评价

    Comprehensive Clinical Evaluation of the Efficacy of Oral Nonsteroidal Anti-inflammatory Drugs in Pain Management

    • 摘要:
      目的 通过对临床使用广泛的口服非甾体抗炎类药品(nonsteroidal anti-inflammatory drugs,NSAIDs)构建并实践科学、规范的临床综合评价,补充此类药品临床综合评价结果,为其他临床药品综合评价工作提供参考。
      方法 温州医科大学附属第二医院药学部为发起单位,组织温州各市县三级及二级医院药学、临床及护理专家,成立“温州市药品临床综合评价组”。在国家及其他省市药评指南/共识、说明书、权威循证医学证据的指导和支持下,通过研讨会、访谈等方式,采用德尔菲法纳入38位药学、临床及护理专家对临床综合评价体系构建及赋分建议,对12个常用口服NSAIDs疼痛管理效果开展临床综合评价。
      结果 此次评价体系采用百分制,评价维度更加细化地兼顾了不同层级医院及不同学科专家的需求,从有效性、安全性、经济性、可及性、适宜性以及创新性6个维度对药品进行量化评分。综合评价结果显示,排名前5的药品为塞来昔布胶囊(西乐葆)、塞来昔布胶囊(优得宁)、美洛昔康片(莫比可)、双氯芬酸钠肠溶片(扶他林)、依托考昔片(安康信)。
      结论 此次工作是该类药品临床综合评价体系构建及结果的补充,可为临床合理用药以及医疗机构目录遴选提供指导建议和决策依据,为其他类药品的临床综合评价体系的构建与实施提供参考。

       

      Abstract:
      OBJECTIVE  To construct and implement a scientific and standardized clinical comprehensive evaluation of oral nonsteroidal anti-inflammatory drugs (NSAIDs), which are extensively used in clinical settings, the findings of such evaluations are complemented, thereby offering references for the comprehensive assessment of other therapeutic agents.
      METHODS  The Department of Pharmacy at the Second Affiliated Hospital of Wenzhou Medical University served as the initiator, coordinating the assembly of pharmacy, clinical, and nursing experts from tertiary and secondary hospitals in Wenzhou to establish the "Wenzhou Drug Clinical Comprehensive Evaluation Group." Guided by national and provincial drug evaluation guidelines/consensus, supported by authoritative evidence-based medical literature, a comprehensive clinical evaluation system was constructed by a panel of 38 pharmaceutical, clinical, and nursing experts using the Delphi method. This panel provided scoring recommendations through seminars and interviews, and a comprehensive clinical evaluation was conducted on the pain management effects of 12 commonly used oral NSAIDs drugs.
      RESULTS  The evaluation system employed a percentage-based system, with a more comprehensive evaluation dimension that considers the specific needs of hospitals at varying levels and experts from diverse disciplines. Drugs were scored quantitatively in six dimensions: efficacy, safety, cost-effectiveness, accessibility, appropriateness, and innovation. The scoring results showed that the top 5 drugs in comprehensive evaluation are Celecoxib (Celebrex), Celecoxib (Homemade), Meloxicam (Mobic), Diclofenac Sodium (Imported), and Etoricoxib (Arcoxia).
      CONCLUSION  This work is a supplement to the construction and results of the clinical comprehensive evaluation system for this type of drug, and it can provide guidance and decision-making basis for the clinical rational use of such drugs and the selection of listed drugs in medical institutions and provide reference for the construction of comprehensive evaluation systems for other drugs.

       

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